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目的:评价甘肃省慢型克山病患者自我管理治疗效果。方法:2018年3 - 6月，选择甘肃省7个克山病病区县院外自我管理治疗的243例慢型克山病患者作为调查对象，收集其一般人口学资料和临床资料。同时，对调查对象进行为期6个月的自我管理治疗，采用自我管理量表评价治疗前及治疗6个月时患者自我管理行为，分值越高表示患者的自我管理行为越好。采用多元线性回归分析进行自我管理量表影响因素分析。结果:剔除信息不完整数据，本次调查共纳入158例慢型克山病患者，其中男性96例、女性62例。与自我管理治疗前比较，自我管理治疗6个月时患者心功能分级和劳动能力均明显改善（n Z = - 4.685、- 5.934，n P均< 0.05）；心胸比较低（0.61 ± 0.08比0.63 ± 0.09，n t = 5.175，n P < 0.05）；心脏彩超指标中，左室射血分数（LVEF）和左室短轴缩短率（LVFS）均较高（0.41 ± 0.11比0.36 ± 0.07，0.21 ± 0.07比0.18 ± 0.05， n t = - 6.504、- 5.391，n P均< 0.05）；自我管理量表总分较高[（53.86 ± 9.29）分比（51.46 ± 10.50）分，n t = - 3.696，n P < 0.05]。患者服药依从性与心功能分级疗效呈正相关（ n r = 0.243，n P < 0.05）。多元线性回归分析显示，文化程度、心功能分级疗效是慢型克山病患者自我管理量表的影响因素（ n t = 2.466、2.635，n P均< 0.05）。n 结论:自我管理治疗可改善慢型克山病患者心脏功能，提高患者自我管理行为能力。“,”Objective:To evaluate the effect of self-management treatment for patients with chronic Keshan disease in Gansu Province.Methods:From March to June 2018, 243 patients with chronic Keshan disease who were treated by self-management treatment outside the hospital in 7 Keshan disease counties in Gansu Province were selected as the survey subjects, and their general demographic and clinical data were collected. At the same time, the survey subjects were given a 6-month self-management treatment, and the self-management scale was used to evaluate the patients' self-management behavior before treatment and 6 months after treatment. The higher the score, the better the patients' self-management behavior. The influencing factors of self-management scale were analyzed by multiple linear regression analysis.Results:Excluding incomplete data, a total of 158 patients with chronic Keshan disease were included in this survey, including 96 males and 62 females. Compared with patients before self-management treatment, the patients' cardiac function classification and work ability improved significantly after 6 months of self-management treatment (n Z = - 4.685, - 5.934, n P < 0.05); cardiothoracic ratio decreased (0.61 ± 0.08 n vs 0.63 ± 0.09, n t = 5.175, n P < 0.05); in the cardiac color Doppler ultrasound indexes, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were increased (0.41 ± 0.11 n vs 0.36 ± 0.07, 0.21 ± 0.07 n vs 0.18 ± 0.05, n t = - 6.504, - 5.391, n P < 0.05); the total score of the self-management scale was increased [(53.86 ± 9.29) scores n vs (51.46 ± 10.50) scores, n t = - 3.696, n P < 0.05]. Further analysis of the efficacy of the patients' cardiac function classification showed that the patients' medication compliance was positively correlated with the efficacy of the cardiac function classification ( n r = 0.243, n P < 0.05). The result of multiple linear regression analysis showed that education level and efficacy of the cardiac function classification were influencing factors of the self-management scale for patients with chronic Keshan disease ( n t = 2.466, 2.635, n P < 0.05).n Conclusion:The self-management treatment for patients with chronic Keshan disease can effectively improve heart function and improve self-management behavior.